Abstract

Introduction

Leptospirosis presents with disease of variable severity; multi-organ failure can
occur. In this situation, plasma exchange has been used with positive results, although
the mechanism of action has not been fully explained.

Case presentation

A 67-year-old Caucasian man developed severe leptospirosis with marked icterus, acute
kidney injury and cardiorespiratory failure, after exposure to livestock. On the basis
of previous reported cases, he was treated with plasma exchange. This led to a rapid
improvement in his bilirubin level, cardiac and respiratory function, followed by
renal function.

Conclusion

We discuss the pathophysiology of the disease, and suggest that plasma exchange has
a role in the treatment of severe sepsis caused by leptospirosis as well as immune
complex-mediated organ injury.